Not in Biden’s America! Wrong! Here comes the story, with necessary background. The key facts are that I was scheduled for simple surgery, admitted to hospital, and then sent home without treatment.
The basics are:
· Involvement of a failing hospital
· Required tests running up insurance costs
· Unnecessary hospital admission procedures with more attendant indemnity costs
· Failure to communicate rigid, senseless rules
· Absolute contempt for the patient and his time
We are dealing with Sibley Memorial Hospital, located in Washington, D.C. It was once a prestigious but now questionable infirmary, especially since its acquisition by Baltimore-based Johns Hopkins Medicine in 2010. The original hospital at North Capitol and Pierce Streets N.W. opened in 1895. Outgrowing its original location, and, after acquiring land on Loughboro Road N.W. in the 1950s, Sibley launched a new, larger facility on May 30, 1961, later expanding and modernizing it in 1999.
Mention Sibley to a medico or someone involved in health care and you get more than raised eyebrows.
At Sibley, Simplicity Becomes Nightmare—With Attendant Costs. On April 21, 2023, I was scheduled for Hammer Toe Repair at that hospital, not far from my house. My toe was sufficiently curled due to weakened foot muscles, that it made walking painful because of pressure on the digit. The simple but ultimately unpleasant fix involves breaking the affected toe, straightening it, and allowing it to heal. I’d had it done years ago on another foot digit and, once the anesthesia wore off, I could hardly think because of the soreness. And this was done in the podiatrist’s office. The podiatrist this time wanted to do it in a hospital where he was admitted. He would do a bone marrow graft and stem-cell treatment which would improve the speed of my recovery. Okay, I thought.
Hammer Toe Representation
I foolishly believed that the procedure would be straightforward. Then I learned I needed beforehand:
· A complete physical examination, including heart and lungs as well as blood work to rule out kidney issues and diabetes
· An electrocardiogram
· X-rays of my foot
This, naturally, drove up insurance costs.
Five days before I would be admitted to the hospital, an unknown Sibley nurse called and ordered me to cease all vitamins (which I believe helped spare me the dreaded COVID 19 virus). She told me where and when to appear at Sibley. And nothing else.
Sibley then bombarded me with a series of encrypted emails about my supposed “account”. Which I knew nothing about and which required usernames and passwords, also unknown to me. I also received two different check-in times, hours apart.
Arriving early for my 9:30 a.m. check-in time, I learned, surprisingly, that I would spend several hours being prepared for the operation and then would be discharged very late in the afternoon. For a toe repair.
Escorted to a room, and required to disrobe completely, I failed to convince the hospital staff that I couldn’t walk without my braces and my shoes. After a bit, a woman came in to insert a tube in a vein for the light anesthetic. A very pregnant nurse “Deena” (no one in America has family names, apparently) then took my blood pressure and checked my blood’s oxygen saturation. “Parisa”, a remarkably unhelpful woman of apparent Iranian extraction, far unlike the Persians I had met in Iran, arrived, announcing she was my anesthetist. She then queried me on how I was getting home. I told her I would take a cab or a hire-car service.
Subsequently, Things Went Downhill. My answer was unacceptable to her. She insisted that I needed someone to ride with me, even though my friends and neighbors were all employed. My nearest relatives live in western Montana, southern Pennsylvania, and southern Maryland. Not anywhere near me and Sibley Hospital. She couldn’t explain why this program was required or why no exception could be made. “It was hospital policy”, she said.
Then I received a steady parade of hospital staff. Alishia Reese, a Registered Nurse and section manager, re-emphasized that this was hospital policy. And that it was for my own good. She had no answer for my question about what horrible things could happen to me between discharge from the hospital and my house, 10 minutes apart by car. Moreover, she could not explain how a person without medical skills could help me in the event “something” occurred during the short ride. She insisted this was for my own good.
I then lambasted her about Sibley’s past “concern” for my well-being. I strongly emphasized and described to her the hospital’s failures involving my earlier “care”:
1. Some years ago, on a Saturday, being remarkably stupid, I attempted to carry a bulky, unwieldy item upstairs without using the handrail. I fell down the flight of steps, unbeknownst to me breaking a vertebra near the end of and protecting the spinal column. After strong pain pills had no effect, the following day I went to Sibley’s emergency room. The doctor there examined me, took X-rays, and pronounced that all I needed was over the counter pain-killers. On the next work-day, I consulted a physician who told me of the fracture, and expressed astonishment at my treatment, noting that the broken vertebra could have made me a paraplegic. On the doctor’s advice, I considered having the fragmented bone glued back together. An orthopedist at Sibley spent only a few minutes with me, handed me a brochure and told me to make an appointment for fixing the issue. Regaining some intelligence, I elected to have an extremely capable surgeon of Iranian heritage at Georgetown University Hospital do the job. She explained the treatment thoroughly, showing me MRIs of my spine. She also promised not to use Elmer’s Glue on the vertebra.
2. In 2016, on a Sunday, taking a box of income tax papers down to the cellar, I somehow managed to tumble down the stairwell—while holding on to the handrail. Not spilling the papers, I nevertheless broke my foot in three places. Calling an ambulance, I went back to Sibley’s emergency room where I spent hours sitting and waiting for them to telephone an orthopedist. (You’d think they’d have a knowledgeable person on staff on the weekend to handle these matters.) After having my foot wrapped, Sibley wanted to send me home—wearing paper shorts in a rainstorm—without something for the excruciating pain. I had a long argument with a nurse about that, noting the nearest drug store, to which the prescription would be phoned, was three blocks from my house and, therefore, inaccessible because I could not walk.
That Was Then; This is Now. After my words with Nurse Reese, Sibley sent in their chief of anesthesia, Jeremy DePue, M.D. He continued the dispute about having the rider/care-giver, and then upped the hospital’s arrogance and contempt for me, the patient. He insisted that I not only have someone accompany me, I also needed a person to spend 24 hours with me in my house “in case something went wrong”. Dr. DePue couldn’t explain why that might happen or what would happen. (After an hour’s worth of surgery, I was to spend several hours recovering from the light anesthesia, called “twilight sleep”. You’re half awake and aware of things around you. But you are not comatose.)
I rebutted this nonsense and said that a sympathetic neighbor couldn’t do this, nor would her husband be enthralled with that plan. Moreover, I told him I would sign a waiver, absolving the hospital of any liability. His reply was, you could still sue us. Then I told him I had a tenant to whom I was renting a room. So there was someone already meeting his requirements. DePue’s idiotic reply was, then have him come and pick you up. I added that the tenant was a Jordanian law student, having neither a driver’s license nor a car. The chief of anesthesia ignored this.
Nurse Reese then returned, bearing Sibley brochures entitled Preparing for Surgery and Passport for Discharge. (I had never seen these.) The first pamphlet recommended using a private medical transportation service to get home from the hospital. However, it didn’t say how much it would cost or who would pay for it. Nor did it say how long in advance you needed to order the conveyance. She then added that there were organizations who would send someone to stay in my house with me to provide “care” for the 24 hours following discharge. There was obviously no consideration given to the dangers, physical and material, of letting a total stranger into your home. In my case, I have numerous valuable as well as sentimental items I had collected through inheritance and my trips abroad with the U.S. Department of State. They are easily concealable and quite portable, such as the Cloisonné vase from Isfahan given me in Tehran in February 2023.
The foregoing idiocy burned up nearly four hours of my time, ruined the podiatrist’s schedule, prevented him from being paid for a basic operation, and jacked up health care costs. Does anybody believe Sibley Memorial Hospital would not charge my insurance for the pre-operative room, staff costs, and procedures, such as inserting a tube into a vein in my hand or taking my blood pressure?
COMMENT: Is this the result of stupidity, arrogance, or total incompetence? Is this the result of age discrimination? (I am no longer a teenager.) Or is it handicap discrimination, given my physical disabilities? Did Sibley “bump” me from the schedule for a more lucrative and better-connected patient? Or is it the result of the United States not having a health care program?
It makes you question Sibley’s claim of being a “teaching hospital”. Its website is emblazoned with the phrase “Safely Caring for You”. Also on its website, Under Patient Rights and Responsibilities is the following, carefully-crafted bunkum:
Your voice matters at Johns Hopkins Medicine, and for your safety, we encourage you to speak openly with your health care team whenever you have questions. When you are well informed, you are more empowered to take part in care decisions and treatment choices.
We are privileged to treat you, and invite you to join us as active members of your health care team…
The site goes on to babble about how well Sibley and Johns Hopkins will deal with you. Inter alia, here are some statements at odds with my treatment:
· Be given considerate, respectful and compassionate care.
· Be given care in a safe environment, free from abuse and neglect.
· Know the names and jobs of the people who care for you.
· Have your culture and personal values, beliefs and wishes respected.
· Be treated without discrimination based on race, color, national origin, age, gender, sexual orientation, gender identity or expression, physical or mental disability, religion, ethnicity, language or ability to pay.
· Have conversations with the Ethics Service about issues related to your care.
In sum, what are we dealing with here? “Pointy-headed intellectuals”, as George Wallace, the deceased Alabama politician put it? Or the “narrow elite’ of the new, emerging upper class, as Charles Murray commented in his book Coming Apart? These are people very well to do, very well educated, and very well divorced from the rest of America’s population.
The United States is the only industrialized country that does not have Universal Health Care. The closest thing to it is Medicare, a health plan for people over 65 years of age. It is also a fee for service operation that reimburses only 80% of charges (with limitations on what it recompenses). Individuals participating in Medicare, besides using Social Security income for the service, must pay monthly for supplemental insurance that covers what Medicare doesn’t. They must also disburse funds for a prescribed drug compensation plan.
According to the Peter G. Peterson Foundation, “[i]n fiscal year 2022, the Medicare program cost $767 billion — about 13 percent of total federal government spending. Medicare was the second largest program in the federal budget last year, after Social Security.”
Healthcare is Different in Civilized Europe. According to a 2015 report from The Week, Switzerland has proved that it’s possible to successfully overhaul an entire country’s health-care system. In 1996, the Swiss re-created their system as a public-private hybrid providing universal health care through a network of private insurers. The system provides what almost everyone agrees is high-quality care, at a cost of less than 11 percent of GDP—compared with 16 percent in the U.S. How does Switzerland do it? The country requires all its citizens to take out personal health insurance, cutting employers out of the picture. Insurers offer a range of programs, and are forbidden from excluding anyone. The government provides a health-care subsidy to help those with lower incomes buy a policy—about 40 percent of the population.
Quo vadimus? (Where are we’uns goin’?) Me, I went home without treatment.